Evaluation of the histological size of the sentinel lymph node metastases using RT–PCR assay: a rapid tool to estimate the risk of non-sentinel lymph node invasion in patients with breast cancer

Veys, Isabelle; Majjaj, Samira; Salgado, Roberto; Noterman, D.; Schobbens, Jean Christophe; Manouach, F; Bourgeois, Pierre; Nogaret, Jean-Marie; Larsimont, Denis; Durbecq, Virginie

doi:10.1007/s10549-009-0555-2

Cited by 10 publications

(6 citation statements)

References 14 publications

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“…Eight papers have been published evaluating the application of qRT–PCR, with promising results ( Table 3 )55–62. The overall sensitivity of qRT–PCR was 78–96 per cent, exceeding that of imprint cytology and frozen section.…”

Section: Molecular Techniques: Quantitative Reverse Transcriptase–polmentioning

confidence: 99%

Intraoperative assessment of sentinel lymph nodes in breast cancer

Layfield¹,

Agrawal

Roché

et al. 2011

Journal of British Surgery

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Background: Sentinel lymph node biopsy (SLNB) reduces the morbidity of axillary clearance and is the standard of care for patients with clinically node-negative breast cancer. The ability to analyse the sentinel node during surgery enables a decision to be made whether to proceed to full axillary clearance during primary surgery, thus avoiding a second procedure in node-positive patients.Methods: Current evidence for intraoperative sentinel node analysis following SLNB in breast cancer was reviewed and evaluated, based on articles obtained from a MEDLINE search using the terms 'sentinel node', 'intra-operative' and 'breast cancer'.Results and conclusion: Current methods for evaluating the sentinel node during surgery include cytological and histological techniques. Newer quantitative molecular assays have been the subject of much recent clinical research. Pathological techniques of intraoperative SLNB analysis such as touch imprint cytology and frozen section have a high specificity, but a lower and more variably reported sensitivity. Molecular techniques are potentially able to sample a greater proportion of the sentinel node, and could have higher sensitivity.

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Section: Molecular Techniques: Quantitative Reverse Transcriptase–polmentioning

confidence: 99%

Intraoperative assessment of sentinel lymph nodes in breast cancer

Layfield¹,

Agrawal

Roché

et al. 2011

Journal of British Surgery

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“…Major advantages of this technique were portended to reduce the workload of pathologists involved in intraoperative analysis of pathology specimens and provide accurate rapid results to the operating surgeon [23]. Evidence also suggested that it could predict additional, non sentinel node metastases [26]. A contentious issue raised however, was the loss of tissue, as part or the entire sentinel node was required to be homogenised to perform the assay.…”

Section: Technical Pointsmentioning

confidence: 99%

Perioperative diagnosis of the positive axilla in breast cancer: A safe, time efficient algorithm

Carroll

O’Mahony

McDermott

et al. 2011

European Journal of Surgical Oncology (EJSO)

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This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Title:Perioperative diagnosis of the positive axilla in breast cancer: A safe, time efficient algorithm.Background: This study evaluates the combined role of axillary ultrasound (Ax US), fine needle aspiration (FNAC) and intraoperative frozen section analysis of the sentinel node (FS SN) in a practical, time efficient algorithm to reduce the requirement for reoperation for axillary clearance in breast cancer in a busy tertiary unit. Methods

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“…On the other hand, a recent study by Veys et al [46] found most PCR-false-negative cases to be associated with borderline expression of genes that most likely corresponded to micrometastases, which appears reasonable since histological size of metastases in SLNs correlates with gene expression levels as measured by qRT-PCR [48,54].…”

Section: Discrepancies Between Histology and Rt-pcr Resultsmentioning

confidence: 87%

“…Secondly, according to Visser et al, the one-step nucleic acid amplification (OSNA) assay (Sysmex Corporation, Kobe, Japan) detects CK19 with high sensitivity (95%) and specificity (97%) after discordant case investigation [43][44][45]. However, since only a single marker is analysed, tumours might be missed, as reported by Veys et al [46] in their study of the BLN assay. RT-PCR for CK19 may sometimes generate false-positive results because of contamination with benign epithelial cells [37].…”

Section: Discussionmentioning

confidence: 99%

Molecular detection of breast cancer metastasis in sentinel lymph nodes by reverse transcriptase polymerase chain reaction (RT-PCR): identifying, evaluating and establishing multi-marker panels

Wallwiener

Kurth

et al. 2011

Breast Cancer Res Treat

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The potential advantage of using quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) methodology to detect metastasis in sentinel lymph nodes (SLNs) of breast cancer (BC) patients was evaluated in this prospective study. We measured the expression of relevant gene transcripts in SLNs using an innovative algorithm and compared the results of single-marker assays versus multi-marker assays with conventional histological detection methods. SLNs from women aged ≥ 18 years diagnosed with unilateral BC were examined by haematoxylin-eosin staining and immunohistochemistry and analysed for transcripts of several relevant genes using qRT-PCR (learning group). Four candidate panels of expressed transcript combinations with high sensitivity and specificity were selected for further investigation. The candidate panels were then validated using SLNs from a second group of BC patients (validation group). In the learning group, 74/314 SLN sections from 150 patients were positive for metastasis by histology. The transcripts analysed showed the following individual sensitivities/specificities: cytokeratin 19 (CK19) 94.6%/97.9%; mammaglobin 1 (MGB1) 82.4%/91.7%; mammaglobin 2 (MGB2) 82.4%/96.7%; carcinoembryonic antigen (CEA) 71.6%/97.5%; EPCAM (epithelial cell adhesion molecule) 91.9%/97.1%; and NY-BR-1 82.4%/93.8%. The optimal panel based on the predefined criteria comprised four markers: CK19, MGB1, EPCAM, and NY-BR-1, of which ≥ 2 had to be positive (95.9% sensitivity, 95.0% specificity, 85.5% positive predictive value (PPV), and 98.7% negative predictive value (NPV)). Overall concordance with histology was 95.2%. In the validation group, 84/315 SLN sections from 235 patients were histologically positive, and panel sensitivity, specificity and overall accuracy were 88.1, 95.2 and 93.3%, respectively, at the SLN section level. In conclusion, molecular staging using expression patterns of relevant transcripts in SLNs could serve as a useful complement to standard diagnostic work-up in BC patients. The proposed flexible multi-parametric approach does not improve the overall accuracy compared with the single-marker approach. However, it overcomes several limitations of the previously reported molecular assays for SLN diagnosis.

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Evaluation of the histological size of the sentinel lymph node metastases using RT–PCR assay: a rapid tool to estimate the risk of non-sentinel lymph node invasion in patients with breast cancer

Cited by 10 publications

References 14 publications

Intraoperative assessment of sentinel lymph nodes in breast cancer

Intraoperative assessment of sentinel lymph nodes in breast cancer

Perioperative diagnosis of the positive axilla in breast cancer: A safe, time efficient algorithm

Molecular detection of breast cancer metastasis in sentinel lymph nodes by reverse transcriptase polymerase chain reaction (RT-PCR): identifying, evaluating and establishing multi-marker panels

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